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A °® CERTIFICATE OF LIABILITY INSURANCE F 1212 12010
<br />Page 1 of 2
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER CONTACT
<br /> NAME:
<br />Willis Insurance Services of California, Inc.
<br />26 Century Blvd. PHONE FAX
<br />M No EXT: 877-945-7378 A/C NO 888-467-2378
<br />P. O. Box 305191
<br />05 E-MAIL
<br />ADDRESS: certificates@willis.com
<br />Nashville,
<br />37230-5191
<br /> INSURER(S)AFFORDING COVERAGE NAIC #
<br /> INSURERA: National Union Fire Ins Co of Pittsburgh 19445-100
<br />INSURED URS Cor
<br />oration dba URS Cor
<br />oration Americas INSURER B: Zurich American Insurance Company 16535-100
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<br />600 Montgomery Street, 26th Floor INSURER C: Insurance Company of the State of PA 19429-100
<br />San Francisco, CA 94111
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<br />INSURER D: Illinois National Insurance Co.
<br />23817-001
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<br />` s of London & British Companies
<br />INSURER E: Lloyd 15792-004
<br /> NSURERF: Lexington Insurance Company 19437-000
<br />COVERAGES CERTIFICATE NUMBER: 15206800 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />
<br />-LDL
<br />TYPEOF INSURANCE DD' SUB
<br />POLICY NUMBER POLICY EFF POLICY EXP
<br />Y
<br />LIMITS
<br />A GENERAL LIABILITY GL4376534 5/1/2010 5/1/2011 EACH OCCURRENCE $ 2,000,000
<br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
<br />PREMISES Eaoccurence
<br />$ 11000,000
<br />
<br /> CLAIMS-MADE OCCUR MED EXP (Anyone person) $ 10,000
<br /> X XCU, BFPD PERSONAL& ADV INJURY $ 2,000,000
<br />
<br /> X Contractual Liability GENERAL AGGREGATE $ 2,000,000
<br />
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,000
<br /> POLICY X PJECT F7 RO- LOC $
<br />B AUT OMOBILE LIABILITY BAP938521501 5/1/2010 5/1/2011 COMBINED SINGLE LIMIT
<br />(Ea accident) 2,000,000
<br />$
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALLOWNED
<br />AUTOS SCHEDULED
<br />AUTOS ?yy !rs}/
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<br />) v BODILY INJURY(Per accident) $
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<br />
<br />HIREDAUTOS NON-OWNED
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<br />i-IJ
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<br />0 !
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<br />A
<br />DAMAGE—
<br /> AUTOS $
<br /> $
<br /> UMBRELLA LIAB OCCUR ,' EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE Lau,, S I( s eccl --"- '' AGGREGATE $
<br /> DED RETENTION$ Assistant (... ,
<br />t y $
<br />C WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY WC20635054/WC20635055 1/112011 1/1/2012 X T RY MIT R
<br />D ANY PROPRIETOR/PARTNER/EXECUTIVE 7 N/A WC20635052 1/1/2011 1/1/2012 E.L. EACH ACCIDENT $ 2,000,000
<br />
<br />A OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
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<br />WC20635051
<br />1/1/2011
<br />1/1/2012
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 2,000,000
<br />
<br />D yes,
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<br />DESCRIPTION OF OPERATIONS below
<br />WC20635053
<br />1/1/2011
<br />1/1/2012
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 2,000,000
<br />E PE0801821/PE0801657 5/1/2010 5/1/2011
<br />F Professional Liability 015438088 5/1/2010 5/1/2011 $1,000,000 Each Claim
<br /> w/Limited Contractual - $1,000,000 Aggregate
<br /> Claims Made Policy
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required)
<br />Re: On-Call Contract for Civil Engineering & Landscape Architecture.
<br />The Workers' Compensation coverage shown above does not apply in monopolistic states. In the
<br />States of ND, OH, WA and WY, Workers' Compensation coverage is provided by the State Fund. In
<br />those States, the above-referenced policies provide Stop-Gap Employers' Liability only.
<br />See Attached
<br />vin , n ,...... w?n l.A1Y l,CLLA I IVIY
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana Public Works Agency
<br />Attn: Tony Olmos
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />Coll:3218136 Tpl:1199784 Cert:152A800 ©1988-2010ACORDt:ORPORATION.All riahtsreserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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